By typing my name in the boxes below, I authorize the Minnesota Bureau of Criminal Apprehension to disclose all criminal history record information to Pearl Crisis Center for employment or volunteer service with this agency.

The expiration of this authorization shall be for a period no longer than one year from the date of my submission.

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Minnesota Statutes, section 245.A.04, subd. 3 authorizes disclosure of all criminal convictions, arrest information, reports regarding abuse or neglect, and investigation results available from local, state, and national criminal history record repositories on all individuals connected with Pearl Crisis Center/Community Closet and other programs. The disclosure of information is authorized after notice is given to the subject of the data. The information will be disclosed to Pearl Crisis Center. The applicant will be informed if the information provided would jeopardize the status of their volunteer application.